Best Way to Get Rid of Under Eye Milia?

I get a lot of tiny little white bumps under my eyes.  Could it be milia?  How can I get rid of them?

Doctor Answers 11

Baby epiderma Inclusion cysts

Milia ( sing. milium, from the Latin millet seed) are small epidermal inclusion cysts ( sometimes erroneously called sebaceous cysts). Milia are totally, benign, tiny keratin-filled cysts. They form when the follicular orifice ( pore) is clogged. For physicians who might chance on this answer, especially those preparing for the boards, milia in the oral cavity in infants are named Epstein pearls.

Unlike blackheads ( open comedones) and whiteheads ( closed comedones), milia do not develop into acne lesions.

Primary milia in infants are the well known "milk bumps" although they have nothing to do with milk and more to do with the immaturity of the pilo-sebaceous ( hair-oil gland) unit. They can be seen later in life when the skin has been irritated, by cosmetics or the sun. They are almost invariable following deep dermabrasion ( not microdermabrasion).

There is a secondary variety which results from other skin condtitioins such as porphyria cutanea tarda,

Milia are easily treated by plucking the roof of the milium with an #11 blade and expressing the contents, either with a comedone extractor or a forceps.

There is usually no extra charge for this procedure.

To prevent further milia: consider switching cosmetics, moisturizers and/or sunscreens, and practicing sun avoidance. A Salicylic Wash and a Retinol or Retinoid are also advised. I would recommend the Salicylic Wash be used in the morning and the Retinoid at night.


Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Extraction is the simplest and most effective away to remove milia.

I agree with the posted comments by the other physicians. Milia, more commonly know as a whitehead, is a ordinary problem. It is easily treated by using a sterile small gauge needle to unroof the lesion followed by extraction of the contents. It should heal with minimal-to-no scarring. The treatment of milia should be performed by a professional!

To prevent milia from forming, I would advise a skin regimen which includes a good cleansing agent and Retinol or Retin-A products. If you are using hairspray, try to avoid this getting on the facial skin, as it can occlude the skin pores.

I hope this helps.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Salycylic Face & Body Wash for prevention

Hello MK,

I would also recommend that once you have the milia extracted you consider using a salycylic acid facial & body wash. With consistent use you can help prevent future milia from forming.

A Benzoyl Peroxide (2.5%) based lotion can also help keep your skin clear from blemishes.

Take Care,

Dr. Jafri

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Extract the milia

We see milia frequently in dermatology.  The best and simplest method is to take a tiny needle or scalpel blade and nick the milia and then use a comdone extractor to remove the contents.  It should heal beautifully and not leave any scarring. 

Take care,

Dr. Groff

William Groff, DO
San Diego Dermatologist
4.8 out of 5 stars 44 reviews

Extractions to treat, vitamin A to prevent

Simple 25-27 G needle to extract.... be careful. This is the easiest way, if needed use an extractor, then to PREVENT milia

1. Use a less occlusive moisturiser
2. Use a Vitamin A cream cautiously. 
3. Exfoliate GENTLY and occasionally. 

Dr Davin Lim
Dermatologist
BRISBANE, Australia

Milia in eye area

These small white bumps can be taken care of by an experienced and licensed esthetician. The way it will be extracted is with with a lancet or small gage needle, there is no down time and heals beautifully within a few days.

Milia extraction

Unroof them with a small needle and what's inside will come out. You can either let it do it on its own, or use a comedone extractor.

Edward S. Lee, MD
Englewood Plastic Surgeon

Not too many alternatives

Milia often appear as little whiteheads that have retained skin appendages in them. The best and slowest treatment is to unroof them with a very fine needle.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Milia Under Eyes

Milia are one of the most common reasons that patients come to my office.  The best way to remove milia is to extract them individually by hand with a comedonal extractor in a sterile procedure. You will have a tiny scab that will heal up in a few days that you can easily cover up with makeup.  Milia are sometimes a result of sweat or oil based products.  Please consult a board certified dermatologist for the best treatment advice.  Microdermabrasion and oxygen facials prevent their formation as well. Best, Dr. Green

Milia

Milia represent a buildup of skin proteins due to pore blockage. Some people are genetically prone to develop milia, and some experience milia because of skin irritation from sun exposure or the use of irritating products. 

The best way to get rid of milia depends on the size, number, and location of the milia. Extraction is generally the best way to remove milia, and involves opening the top of the milia with a needle or knife and pushing out the contents. For numerous, small milia, exfoliation using peels and retin-a can help, along with avoiding any pore clogging creams, lotions, or products. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.